The purpose of this research is to further develop the criteria mapping method for quality assessment in emergency departments for two patient problems: chest pain and abdominal pain. In the current grant, map process scores based on this branching logic method have been shown to correlate with health outcomes for chest pain patients in two emergency departments. We propose to study the generalizability of this chest pain system in two new emergency departments. In addition to continuing to use outcomes to demonstrate the validity of the map system, two other issues will be addressed: the reliability of hospital based abstractors and the correlation of map scores with peer-identified deficiencies. A second criteria map system will be developed to evaluate the quality of care for patients with abdominal pain. Outcomes will again be used to test the validity of the quality assessment method in two hospital emergency departments. For both patient problems, a set of implementation (training) materials will be developed, including cost and performance information and training manuals which will enable amy ED to use the criteria mapping method to identify charts which are likely to contain deficiencies.